[A complete intermediate temporomandibular joint prosthesis. Evaluation after 6 years].
Since 1983 we have inserted more than 100 temporomandibular joint prostheses. A review after 6 years allows the respective indications to be listed and the complications to be studied in 72 insertions involving 62 cases suitable for analysis. The prosthesis is a total intermediary prosthesis forming an unsealed cupula composed of 2 halves--a mandibular portion and a temporal portion. Insertion of the prosthesis requires preliminary facial nerve dissection then osteotomy of the mandibular condyle and its subsequent drilling to allow the screwing in of the prosthesis. The prosthesis was used in traumatology, in condylar and high sub-condylar fractures, in the event of failure of functional treatment, in malformation syndromes, in tumors and, finally, in degenerative pathology. 13 prostheses were removed. A study of the probable causes of complications shows a predominance of technical problems related to inaccurate positioning of the prosthesis, in that it was not placed in the axis of the condyle, or that inadequate bicortical support was present. In our opinion, these complications do not question the conception of the prosthesis but rather indicate that it is necessary to perfect the insertion technique while taking advantage of improvements in the prosthesis which are currently under study.
Chassagne
J F
JF
Service de Chirurgie Maxillo-faciale, CHR, Nancy.
Flot
F
F
Stricker
M
M
Dinh Doan
G
G
Briche
D
D
Nouri
K
K
D000844:Ankylosis / Q000601:surgery; D001859:Bone Neoplasms / Q000601:surgery; D006801:Humans; D007595:Joint Prosthesis / Q000009:adverse effects / Q000706:statistics & numerical data; D008335:Mandibular Condyle / Q000601:surgery; D010027:Osteotomy / Q000379:methods; D011183:Postoperative Complications; D011474:Prosthesis Design; D013704:Temporomandibular Joint / Q000293:injuries / Q000601:surgery; D013705:Temporomandibular Joint Disorders / Q000601:surgery
Prothèse totale intermédiaire d'articulation temporo-mandibulaire (A.T.M.). Bilan après 6 ans.